In vivo reflectance confocal microscopy on the lip: From normal to sun damaged skin and non-melanocytic skin cancer

Introduction: Reflectance confocal microscopy (RCM) is a non-invasive technique that has demonstrated its utility in the diagnosis of melanocytic and non-melanocytic skin lesions. It could help us differentiate sun damage from neoplastic conditions of the lip.
Objective: To report RCM features of the lips, defining the characteristics of healthy lips on its different anatomic areas (external area, vermillion and inner mucosa) and ranges of sun damage until skin cancer.
Material and Methods: Retrospective and prospective study including 30 subjects enrolled at the Sydney Melanoma Diagnostic Centre (Royal Prince Alfred Hospital, RPA, Sydney), Melanoma Institute Australia (MIA, Sydney) and San Gallicano Dermatological Institute (Rome, Italy) during a period of 3 months (April-June 2013). Two groups were recruited: Group 1 were healthy volunteers to describe RCM features of different anatomical parts of the lip and as a control group for sun-damaged lips; Group 2 were patients with non-pigmented lesions on the lips, diagnosed clinically and with dermoscopy as actinic cheilitis, leukoplakia or SCC. RCM features were evaluated by two investigators (HC, PU) and reviewed by one expert observer (PG), blinded from clinical information and dermoscopy images. Lesions suspicious of malignancy either clinical, dermoscopic and/or under confocal microscopy evaluation were biopsied, following the standard clinical practice.
Results: RCM features of each part of the lip are described in healthy lips. Features of sun-damaged lips, actinic cheilitis and SCC are described and compared to control lips.
Conclusions: RCM is a good diagnostic tool to examine healthy and pathological lip with adequate histological correlation.

Dr. Helena Collgros

Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, NSW

Dr Helena Collgros (MD) obtained a bachelor in Medicine from the Faculty of Medicine of the Autonomous University of Barcelona (2003-2009). She completed her Dermatology and Venereology specialization in Barcelona in 2014. Afterwards she worked as a dermatologist in the public university hospital Germans Trias i Pujol in Barcelona (2014-2016). Her fields of expertise and research interests include pigmented lesions, melanoma, skin cancer and imaging techniques. She has authored and co-authored more than 20 publications in National and International Journals. She is currently working at the Sydney Melanoma Diagnostic Centre at the Royal Prince Alfred Hospital in Sydney, covering an Area of Need Position attending patients at high risk for developing melanoma and skin cancer. She performs dermoscopy, digital monitoring and in vivo confocal microscopy.